PURPOSE: Lower urinary tract symptoms (LUTS) are common in elderly men. Radical prostatectomy may relieve obstructive symptoms, whereas radiation therapy may exacerbate obstructive or irritative symptoms. Baseline LUTS rates are unknown in populations screened for prostate cancer (PCa). Thus, it is difficult to determine the changes in LUTS that can be attributed to PCa treatment. Therefore, we assessed baseline rates of LUTS in a PCa screening cohort and assessed which of the International Prostate Symptom Score (IPSS) symptoms had the most detrimental effect on quality of life (QoL). METHODS: The IPSS was completed by 1273 men without clinical evidence of PCa who participated in an annual PCa screening event. Presence of irritative or obstructive symptoms was considered when they were reported at least two of five times. Using linear regression analyses, we evaluated the effect of each questionnaire symptom on the IPSS QoL domain. RESULTS: Mean age was 57.6 years (range 40-89 years). Of all in the cohort, 40% (n = 472) reported moderate to severe LUTS (IPSS score > or =8), and 21% (n = 255) were mostly dissatisfied with this condition. Irritative symptoms were reported by 39% (n = 495) and obstructive symptoms by 37%. Of all IPSS symptoms, urinary straining was associated with the least favorable QoL, followed by urinary frequency. CONCLUSION: More than one-third of persons at risk of PCa are affected by either irritative or obstructive symptoms, and one in five of these men is bothered by LUTS. Because PCa treatment may exacerbate LUTS, the severity and impact on QoL should be considered carefully before diagnosis and/or treatment.
